血清HMGB1、IGF-1、ficolin-3在重症颅脑损伤患者中的表达及预后价值

目的探究高迁移率族蛋白1(HMGB1)、胰岛素样生长因子-1(IGF-1)、纤维胶凝蛋白3(ficolin-3)在重症颅脑损伤患者中的表达及预测预后价值。方法选取本院2017年6月至2019年6月重症颅脑损伤患者62例作为观察组,另选取同期轻中度颅脑损伤患者65例作为对照组。统计对比两组血清HMGB1、IGF-1、ficolin-3水平,并随访28 d,比较不同Rankin量表(MRS)及格拉斯哥预后(GOS)评分患者各血清水平,Spearman等级相关分析各血清与MRS、GOS评分相关性,受试者工作特征(ROC)曲线分析预后预测价值,Kaplan-Meier(KM)曲线分析生存状况。结果观察组血清HMGB1水平高于对照组,IGF-1、ficolin-3水平低于对照组(P<0.05);入院第3、5 d神经功能恢复良好者血清HMGB1水平低于神经功能恢复不良者,IGF-1、ficolin-3水平高于神经功能恢复不良者(P<0.05);入院第3、5 d预后良好者血清HMGB1水平低于预后不良者,IGF-1、ficolin-3水平高于预后不良者(P<0.05);血清HMGB1与MRS评分呈正相关,与GOS评分呈负相关,血清IGF-1、ficolin-3与MRS评分呈负相关,与GOS评分呈正相关(P<0.05);ROC曲线分析显示,血清HMGB1、IGF-1、ficolin-3水平入院后第5 d AUC大于入院第3 d;经KM曲线分析显示,血清HMGB1、IGF-1、ficolin-3高危组、低危组生存曲线存在差异,有统计学意义(P<0.05)。结论血清HMGB1、IGF-1、ficolin-3水平在重症颅脑损伤中呈异常表达状态,与神经功能损伤密切相关,动态监测上述血清水平,可为临床评估脑损伤程度、预测预后提供科学指导。

Expression of serum HMGB1,IGF-1 and ficolin-3 in patients with severe head injury and their prognostic value analysis

Objective To investigate the expression and prognostic value of high mobility group box 1(HMGB1),insulin?like growth factor?1(IGF?1)and fibronectin?3 in patients with severe head injury.Methods 65 patients with severe craniocerebral injury from June 2017 to June 2019 in our hospital were selected as the observation group,and 65 patients with mild to moderate craniocerebral injury were selected as the control group.The serum levels of HMGB1,IGF?1 and ficolin?3 were measured and compared for 28 days.The serum levels of patients with different Rankin scale(MRS)and Glasgow prognosis(GOS)scores were compared.Spearman rank correlation analysis was used to correlate the sera with MRS and GOS scores,the receiver operating characteristic(ROC)curve was used to analyze the prognostic value,and the Kaplan?Meier curve was used to analyze the survival status.Results The serum HMGB1 level in the observation group was higher than that in the control group,and the levels of IGF?1 and ficolin?3 were lower than those in the control group(P<0.05).The serum HMGB1 levels in patients with good neurological function recovery on the 3rd and 5th day after admission were lower than those with poor neurological function recovery.The levels of IGF?1 and ficolin?3 were higher than those with poor neurological function(P<0.05).The serum HMGB1 levels were lower in patients with good prognosis on the 3rd and 5th day after admission,and the levels of IGF?1 and ficolin?3 were higher than those with poor prognosis(P<0.05).Serum HMGB1 was positively correlated with MRS score and negatively correlated with GOS score.Serum IGF?1 and ficolin?3 were negatively correlated with MRS score,and positively correlated with GOS score(P<0.05).ROC curve analysis showed that serum HMGB1,IGF?1,and ficolin?3 levels were higher on the 5th day after admission than on the 3rd day after admission;The KM curve analysis showed that there were differences in the survival curves of serum HMGB1,IGF?1,ficolin?3 high?risk group and low?risk group,which was statistically significant(P<0.05).Conclusion Serum HMGB1,IGF?1,and ficolin?3 levels are abnormally expressed in severe craniocerebral injury,and are closely related to neurological impairment.Dynamic monitoring of the above serum levels can provide scientific guidance for clinical assessment of the degree of brain injury and prediction of prognosis.